Comparison of hematopoietic progenitor cell collection using different inlet flow rates with the Fenwal Amicus.

Purpose: We have used a hematopoietic progenitor cell (HPC) algorithm (standard [STD]) that restricted the inlet flow rate to 65 mL/min for peripheral white blood cell count (PWBC) >35 × 10 /L (STD). In this study, we evaluated a technique that allows 85 mL/min, regardless of the PWBC count (high). For patients with PWBC >35 × 10 /L, a prospective, randomized comparison of the high flow rate vs the STD PWBC-based flow rate (65 mL/min) was performed, comparing CD34+ and lymphocyte yields, collection efficiencies (CE1), mononuclear cells (MNC), and granulocytes, red blood cell (RBC), and platelet content.

Infused Autograft Absolute Lymphocyte Count Predicts Superior Survival in Diffuse Large B Cell Lymphoma Patients Post-Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation: A Matched Case-Control Study.

Our group published a double phase III trial showing that patients infused with an autograft absolute lymphocyte count (A-ALC) ≥0.5 × 10 cells/kg experienced superior survival post-autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT). Based on the results from our phase III study, as well as published retrospective studies, on April 1, 2017, our Bone Marrow Transplant Program changed our standard practice to collect an A-ALC ≥0.

Paired comparison of therapeutic plasma exchange using the Fenwal Amicus versus TerumoBCT Spectra Optia.

Purpose: Terumo BCT Spectra Optia (O) and Fenwal Amicus (A) can perform therapeutic plasma exchange (TPE). We compared these systems in a prospective, randomized, crossover study of 81 paired procedures. Primary objective was to determine if there was a difference in platelet loss between the instruments.

Iatrogenic thyrotoxicosis and the role of therapeutic plasma exchange.

Thyroid storm or severe thyrotoxicosis results from extreme thyroid hormone elevation. Therapy includes medical management to prevent hormone production, release, recycling, and peripheral conversion while stabilizing adrenergic tone. Thyroid dysfunction is the usual cause but it can be due to excessive thyroid hormone ingestion.

Comparison of two double red cell collection settings on Fenwal Alyx apheresis instrument.

The Fenwal Alyx for collecting double red cell products has two red cell volume collection settings: fixed collection target of 360 ml (180 ml/unit) and a variable target of collecting either 400 or 360 ml (200 or 180 ml/unit), where the machine aims for the higher possible collection target. We retrospectively compared the two collection targets for the RBC content, donor time, technician time, and collection efficiency. We compared 18 fixed (F) target collections to 40 variable (V) target collections.

Double red blood cell collection: comparison of three apheresis systems.

Background: We compared three instruments for double red blood cell (DRBC) collection to efficiently optimize our RBC inventory.

Study Design And Methods: Instruments compared were the TerumoBCT Trima Accel (Trima), the Fenwal Alyx (Alyx), and the Haemonetics MCS+ 8150 (MCS+). Forty consecutive collections (80 products) per instrument were evaluated for hemoglobin (Hb) content, leukoreduction, collection time, instrument efficiency, donor acceptance, and reactions.

Immunologic Autograft Engineering and Survival in Non-Hodgkin Lymphoma.

Retrospective studies have reported that the collected and infused autograft absolute lymphocyte count (A-ALC) affects clinical outcomes after autologous peripheral hematopoietic stem cell transplantation (APHSCT). We hypothesized that manipulation of the apheresis machine to target a higher A-ALC dose would translate into prolonged progression-free survival (PFS) in patients with non-Hodgkin lymphoma (NHL) undergoing APHSCT. Between December 2007 and October 2010, we performed a double-blind, phase III, randomized study randomly assigning 122 patients with NHL to undergo collection with the Fenwal Amicus Apheresis system with our standard settings (mononuclear cells offset of 1.

A multicenter evaluation of a new therapeutic plasma exchange procedure.

Background: The AMICUS (Fenwal, Inc.) was cleared in the United States for platelet (PLT) and plasma collection in 1996 with subsequent clearances for the collection of other blood products. Although not previously used for therapeutic plasma exchange (TPE), new disposables, software, and hardware were developed to enable TPE on the AMICUS.

Comparison of hematopoietic progenitor cell collections using the COBE Spectra version 7 and Amicus version 3.1 for patients with AL amyloidosis.

To address concerns about infused fluid volume during HPC collections in patients with AL amyloidosis, our institution has used a 26:1 anticoagulant (AC) ratio on the COBE Spectra and on the Fenwal Amicus. In this study, in a cohort of AL amyloid patients, we compared the Amicus version 3.1 to the Spectra version 7 MNC collections with regard to infused fluid volume, CD34+ cell yield, lymphocyte yield, cross-cellular content, and adverse reactions.

Manual color monitoring to optimize hematopoietic progenitor cell collection on the Fenwal Amicus.

A technique was developed to improve consistency of MNC transfers from the centrifuge to the collection bag in the Fenwal Amicus. The operator assures that RBCs completely fill the cassette by the end of the transfer by adjusting the RBC offset in succeeding cycles. We compared yields and crosscellular content before and after implementation of the monitoring technique.

Use of various offset settings in the Fenwal Amicus during hematopoietic progenitor cell collection to increase lymphocyte yield and reduce cross-cellular contamination.

Introduction: Autologous HPC collection focus has been CD34+ cell yield but product content of other cells is important for patient survival, complications, and resource utilization.

Methods: Prospective, paired study examining MNC and RBC offsets (opens and closes collect valve, respectively) was performed using Fenwal Amicus. Lymphocyte, CD34+ cell yields, and cross-cellular contamination were compared using different MNC/RBC offsets and retrospective Spectra data.

Concentration changes to counteract the effects of bacteriological sampling on PLT yields.

Introduction: Bacterial culturing of apheresis platelet (PLT) units appeared to increase the incidence of low yield products of <3.0 x 10(11) PLT (LYP) and decrease the incidence of multiple PLT products. To determine the effects of sampling and subsequent modifications in collections on PLT yield and adverse reactions, a retrospective analysis was performed.

The effect of double- and triple-apheresis platelet product donation on apheresis donor platelet and white blood cell counts.

Background: Concerned about the effect of multiple platelet (PLT) product donation on donor health, in 2005 the FDA proposed restrictions limiting the number of PLT products donated in 12 months. This was based on limited published evidence. To provide information on the effect of PLT donation on PLT and lymphocyte (LYM) count, hematologic variables were examined in a group of multiple PLT product donors.

Treatment of chronic dilated cardiomyopathy with immunoadsorption using the staphylococcal A-agarose column: a comparison of immunoglobulin reduction using two different techniques.

Auto-antibodies to myocardial antigens have been implicated in the pathogenesis of chronic dilated cardiomyopathy (DCM). A protein A immunoadsorption affinity column system was used to remove IgG antibodies, particularly IgG3. Two techniques, the standard technique (T-1) used for removal of IgG Factor VIII inhibitors and a technique (T-2) designed to enhance IgG3 removal and address issues in venous access, minimize positive fluid balance, and adverse reactions were compared.

A pilot study to assess the use of protein a immunoadsorption for chronic dilated cardiomyopathy.

Dilated cardiomyopathy (DCM) is a leading cause of end-stage heart failure and cardiac transplantation. Anticardiac antibodies are common and removal of these through immunoadsorption (IA) is associated with improvement in global cardiac function. The effect of IA on regional function and quality of life (QOL) without intravenous immunoglobulin (IVIG) substitution has not been described.

Blood component collection by apheresis.

Apheresis component collection is a rapidly growing area in the blood collection field. Several instruments with varying capabilities are available. This is a brief review of the equipment available for granulocyte and apheresis component collection and indications for their use.

Paired comparison of Gambro Trima Accel versus Baxter Amicus single-needle plateletpheresis.

Background: Gambro BCT recently introduced the Trima Accel Version 5 (TR) plateletpheresis machine. Platelet (PLT) yields, collection efficiencies (CEs), numbers of white blood cells (WBCs), and processing times of the TR versus the Amicus (Version 2.51) single-needle (AM) procedures were evaluated by use of a prospective paired comparison.

Hematopoietic progenitor cell large volume leukapheresis (LVL) on the Fenwal Amicus blood separator.

A technique for large volume leukapheresis (LVL) for hematopoietic progenitor cell (HPC) collection using the Fenwal Amicus is presented. It was compared to standard collections (STD) with regard to CD34+ cell yields and cross-cellular content. Optimal cycle volumes and machine settings were evaluated for LVL procedures.